Thursday 29 January 2026
Long-Term Care and Aging Populations
13:00 - 13:15
Population‑attributable fractions of dementia risk factors in older Japanese: difference in rural and urban areas
| Presenter | : | Yiyi Yang |
| Abstract ID | : | A239 |
Objective
Evidence on population-attributable fractions (PAFs) of modifiable dementia risk factors, particularly regarding regional disparities, is limited in Japan. We aimed to estimate weighted PAFs of dementia attributable to 11 modifiable risk factors (low education, hypertension, diabetes, hearing loss, vision loss, current smoking, excessive drinking, physical inactivity, obesity, depression, and social isolation) across rural and urban areas.
Methods
In the Japanese Gerontological Evaluation Study (JAGES), 29,085 adults aged ≥65 years from 26 municipalities were assessed of their lifestyles and health conditions via questionnaires and health checkups. Incident dementia was identified through Japan's Long-term Care Insurance System, with follow-up from 2010 up to 2019. Weighted PAFs were estimated using age and sex-standardized prevalence and age- and sex-adjusted risk ratio estimates, stratified by rural, semi-urban, and urban areas.
Results
Among participants, 26.3% lived in rural, 45.2% in semi-urban, and 28.4% in urban areas. Nine modifiable risk factors (except hypertension and excessive drinking) accounted for 18% of dementia in older Japanese overall (18.5% in rural, 17.1% in semi-urban, and 21.1% in urban areas). Across all area types, physical inactivity accounted for 3.7–4.5% of dementia risk, while depression and social isolation contributed 3.8–5.2% and 3.1–4.4%, respectively. Low education contributed to dementia risk only in semi-urban and urban areas (2.8% and 2.6%, respectively). Diabetes, hearing loss, and vision loss contributed most prominently in rural areas (2.0%, 1.5%, and 1.3%, respectively).
Discussion
Nine risk factors accounted for dementia risk in older Japanese across regions. Physical inactivity, depression, and social isolation contributed largely across all settings, while low education was more prominent in semi-urban and urban areas, and health conditions (including diabetes, hearing loss, and vision loss) more prominent in rural areas.
Conclusion
Modifiable risk factors accounted for dementia risk in older Japanese, with certain regional disparities.
Poster Slot
A01
13:00 - 13:15
Harnessing Intergenerational Health Gains and Long-term Care Insurance for Equity-Driven Ageing Policy: Evidence from the Flynn Effect in China
| Presenter | : | Xinye Ma |
| Abstract ID | : | A016 |
Objective
As China undergoes a profound demographic transition, understanding health trends across generations and identifying policy responses are crucial for fostering equity and resilience. This study investigated intergenerational health improvements the Flynn effect, and evaluated impact of long-term care insurance (LTCI) to identify policy innovations for navigating ageing as an opportunity.
Methods
Using five waves of nationally representative data from China Health and Retirement Longitudinal Study (CHARLS, 2011-2020), we constructed age-period cohorts of adults aged 45-85 to examine health outcomes, specifically self-rated health, chronic disease, disability, and limitations in activities of daily living (ADL). Oaxaca-Blinder decomposition was applied to unpack drivers of cohort differences, and a PSM-DID approach evaluated effects of LTCI pilot schemes.
Results
Strong evidence of the Flynn effect in health was observed: later-born cohorts exhibited better self-rated health (+0.099, +0.066, +0.134, +0.144 on five-point scale, with all p<0.01), fewer chronic diseases (-0.665, -0.746, -0.633, -0.427 among fourteen diseases, with all p<0.01), lower disability prevalence (-0.117, -0.042, -0.030, -0.012 among five types of disability, with all p<0.01). Fewer ADL limitations were found within individuals under 65 years old (-0.068, -0.089 for 56-64 and 46-54 years old, both p<0.01). Decomposition attributed majority of improvements to health behaviors and early-life factors. The LTCI scheme significantly reduced ADL limitations (-0.117, p<0.01), with stronger effects in under-resourced regions and among women.
Conclusion
The results underscore potential for proactive, equity-oriented policy measures to transform population ageing into an opportunity. Intergenerational health improvements provide a foundation for harnessing the "silver dividend", while LTCI proves adaptive policies redress geographic and gender disparities. China should prioritize early interventions of physical disfunction, scale LTCI coverage in under-resourced regions and integrate life course approaches to health promotion. China’s strategies offer transferable insights for LMICs navigating similar demographic transitions, contributing to global effort toward equitable and sustainable ageing systems.
Poster Slot
B01
13:00 - 13:15
Health System Resilience and Community Workforce Adaptation during the COVID-19 Crisis in Thailand: Lessons for Age-Friendly and Inclusive NCD Care
| Presenter | : | Orawan Tawaytibhongs |
| Abstract ID | : | A023 |
Background/Introduction
The COVID-19 pandemic disrupted non-communicable disease (NCD) care globally, with older adults and vulnerable populations experiencing the most significant impacts. In Thailand, the primary healthcare system—anchored by community health workers and village health volunteers—faced substantial challenges in maintaining continuity of care while responding to evolving public health demands. Understanding how community-based systems are adapted provides critical insights for strengthening resilient, age-friendly NCD services during future crises.
Objectives
This study examined: (1) adaptations in NCD service delivery implemented by Thailand’s community health workforce during COVID-19; (2) barriers and facilitators to maintaining age-friendly care; (3) innovative service models emerging during the crisis; and (4) implications for strengthening inclusive NCD systems in resource-constrained settings.
Methodology
A mixed-methods study was conducted in urban and rural districts (2020–2023). Quantitative analysis of service utilization involved primary care units serving more than 50,000 registered NCD patients, comparing the pre-pandemic (2019) and pandemic (2020–2022) periods. Qualitative data included 45 interviews with community health workers, village health volunteers, and administrators, complemented by focus group discussions with 60 older adults with NCDs. Thematic analysis explored adaptation strategies and resilience factors.
Results/Major Findings
The community health workforce demonstrated strong adaptability through: home-based medication delivery reaching 78% of homebound older adults; telephone-based monitoring maintaining contact with 85% of high-risk patients; outdoor community clinics that reduced transmission risk; and peer support networks mobilizing older adults as health champions. Service utilization initially declined by 40% (March–June 2020) but recovered to 95% of baseline by December 2020. Disparities persisted, with rural areas recovering faster than urban ones, and mobility-impaired older adults experiencing prolonged service gaps. Key resilience factors included established community trust, flexible policy guidance, and informal inter-professional collaboration.
Conclusion/Lessons Learned
Thailand’s community health workforce played a pivotal role in maintaining continuity of NCD care during COVID-19. Emergency-driven innovations—primarily home-based services and remote monitoring—proved effective for age-friendly care and warrant institutionalization. Remaining gaps highlight the need for tailored strategies for urban poor and mobility-impaired older adults, underscoring that resilience relies not only on system capacity but on empowered, trusted community health workers.
Poster Slot
D01
13:00 - 13:15
Equity-Centred Innovation for Ageing Populations: A Mixed-Methods Study of Respectful and Responsive Elderly Care in Singapore
| Presenter | : | Taufique Joarder |
| Abstract ID | : | A035 |
As Singapore confronts rapid ageing, the transformation of its health system to deliver respectful, responsive, and dignified care to the elderly has become a policy priority and a test case for equity-centred innovation. This mixed-methods study employed 21 in-depth interviews, 10 focus group discussions, and a structured survey of 264 seniors to uncover the nuanced realities of care experiences and expectations among the elderly in Singapore. Findings reveal that while interpersonal communication and clinical respect are generally well-rated, substantial gaps persist in system responsiveness, particularly in financial navigation, waiting times, care coordination, and holistic support for psychological and social needs. Notably, digitally excluded, socioeconomically vulnerable, or minority-language seniors remain at heightened risk of exclusion. The study’s validated Respect, Needs, and Priorities survey instrument demonstrates technical rigour (α > 0.9) and yields actionable segmentation of elderly users, allowing for targeted interventions—such as tailored transport support or alternative appointment systems for digitally marginalised groups. The introduction of a “structural respect” framework marks a conceptual innovation, reframing dignity in care as both interpersonal and systemic, with implications for provider training, resource allocation, and the design of age-friendly health policies. Policy relevance is underscored by recommendations to integrate community-trusted access pathways, adopt differentiated service models, and embed respectful care metrics into national quality frameworks such as Healthier SG. By employing a solution-oriented, equity-focused approach, this research offers a practical blueprint for scaling up inclusive, responsive service delivery—meeting the changing health needs of ageing populations while ensuring that no segment is left behind. Ultimately, the findings inspire collective action to design health systems where respect, responsiveness, and dignity are not privileges, but the standard for all older adults navigating demographic transitions in Singapore and beyond.
Poster Slot
E01
13:15 - 13:30
Promoting Lifelong Mobility: Japan’s Orthopaedic Campaign to Combat Locomotive Syndrome
| Presenter | : | Keiko Yamada |
| Abstract ID | : | A063 |
As the world’s most aged society, Japan faces urgent challenges in maintaining mobility and independence across the life course. To address these needs, the Japanese Orthopaedic Association (JOA) introduced Locomotive Syndrome in 2007 as a framework for recognizing and preventing mobility decline due to musculoskeletal impairment. LS emphasizes that musculoskeletal health underpins physical independence from childhood through older age, and that deterioration often begins in midlife rather than old age. Given that musculoskeletal disorders account for nearly one-quarter of all long-term care needs in Japan, LS awareness was adopted as a national public health target in Health Japan 21 (Second Term) in 2013.
Public awareness has since risen from 17% (2012) to approximately 42% (2025). Increasing polarization of children’s physical activity—characterized by both overuse injuries and insufficient activity—further underscores the need for life-course musculoskeletal health strategies. To promote prevention, JOA collaborates with local governments, healthcare professionals, public media, and digital platforms to disseminate functional assessments (stand-up test, two-step test, GLFS-25) and targeted exercise programs such as “Locomotion Training.”
Research on LS has expanded rapidly, with more than 520 PubMed-indexed papers to date. Policy integration has also progressed: national fall-prevention guidelines for older workers now include LS/frailty prevention, and the 2022 Medical Society Declaration—endorsed by the Japan Medical Association and 80 academic societies—recognized LS/frailty prevention as a national medical priority.
Key lessons include the necessity of early detection beginning in midlife, targeted strategies for children and working-age adults, and the central role of musculoskeletal health in delaying frailty and reducing long-term care needs. Japan’s community-based, preventive model offers a scalable approach for aging societies seeking to extend healthy life expectancy.
Poster Slot
A02
13:15 - 13:30
Strengthening Oral Health Systems under Thailand’s Decentralization Reform
| Presenter | : | Rattanun Losupakarn |
| Abstract ID | : | A098 |
Oral health services have long been part of primary health care level. Dental nurses are the backbone in providing oral health preventive and promotive care. Under the decentralization policy, a major reform was in 2022 to transfer Sub-District Health Promoting Hospital from the Ministry of Public Health (MOPH) to the Provincial Administrative Organizations (PAOs). PAOs then have flexibility in mobilizing budget, staff, and service design for more responsive care in relevant with local needs and demographic challenges.
To understand the dynamics post-transfer, the Bureau of Dental Health conducted field visits from eight provinces in 2024. Initiatives to strengthen oral health care based on local context can be observed in many areas. In Chiang Rai, where over a quarter of the population is elderly, a home-based oral care program was introduced for bed-ridden groups. Prachinburi, with a growth rate below 0.4%, initiated school-based oral health services through strong interagency collaboration aiming for caries free among children. Phuket expanded service coverage through public–private partnerships and workforce investment. These examples highlight roles of local authorities, and community to build equitable and resilient health systems, with local innovation.
However, key challenge is that dental nurses were transferred to local authorities, while dentists remained under MOPH. This separation may lead to disrupted referral systems reflected by a 10–20% decline in preventive oral health coverage in some areas.
To tackling this challenge, the Bureau of Dental Health developed the operational guidelines, organized experience sharing platforms across areas, and strengthened capacity of dental nurses. Further efforts should focus on strengthening oral health systems including referral systems, empowering community in particular village health volunteers, integrating data systems for effective monitoring, and underpinning sustained coordination between MOPH–PAO to ensure inclusive, quality oral health care based on local context for good oral health of all age groups.
Poster Slot
B02
13:15 - 13:30
The Mediating Role of Social Support in the Relationship Between Intergenerational Proximity and Older Adult‘s Well-being: Evidence from China
| Presenter | : | Xiaoyi Yu |
| Abstract ID | : | A103 |
Objective: This study examines the mediating role of social support in the relationship between children's proximity and older adults' well-being in China. As population aging accelerates and family structures change, understanding how intergenerational residential distance affects elderly well-being through social support mechanisms is crucial for developing effective support policies.
Methods: Using four waves of CLHLS data (2008–2018), this study analyzed 2,054 older adults aged 65+ across 22 Chinese provinces (8,216 person-wave observations). Children's proximity was classified into six levels from coresiding to living elsewhere. Four well-being outcomes were assessed: self-rated quality of life, self-rated health, cognitive function, and depressive symptoms. Two-way fixed effects models controlled for individual heterogeneity and temporal trends. Baron and Kenny mediation analysis examined three potential pathways: emotional, informational, and tangible support.
Results: Compared to older adults whose children live elsewhere, those with children in the same district or closer reported significantly higher quality of life (β=0.233–0.280, p<0.05–0.01). For depressive symptoms, same-neighborhood or coresiding arrangements showed significant reductions (β=-0.846 to -1.834, p<0.05–0.01). Closer proximity was significantly associated with increased emotional and informational support (β=0.235–0.509 and β=0.294–0.421, respectively), but not tangible support. Mediation analysis revealed that informational support fully mediated effects on quality of life, while emotional support partially mediated effects on depressive symptoms. Subgroup analyses demonstrated significant heterogeneity: effects were more pronounced among women, individuals without primary education, and older cohorts (>75 years), while males and younger elderly showed no significant associations.
Conclusion: Informational and emotional support from children serve as key mediating mechanisms linking proximity to elderly well-being, with informational support affecting quality of life and emotional support alleviating depression. Stronger effects among women, less-educated, and older adults reflect cumulative disadvantage patterns. These findings inform intergenerational support policies amid urbanization challenges to traditional family structures.
Poster Slot
C02
13:15 - 13:30
Village health worker care model to reduce cardiovascular disease risk among conflict-affected populations: a cluster randomized controlled trial in eastern Myanmar
| Presenter | : | Adam Kimball Richards |
| Abstract ID | : | A146 |
Background: Due to demographic and epidemiologic transitions, cardiovascular disease (CVD) is the top cause of death and disability among crisis-affected populations in Asia. Humanitarian health systems lack evidence-based care models capable of achieving high coverage of effective treatments to reduce CVD risk in areas of active armed conflict.
Methods: We conducted a cluster randomized controlled trial of a Village Health Worker (VHW) care model to screen for and treat hypertension, diabetes, and high CVD risk in 13 villages in Southeast Myanmar. The primary outcome was the proportion of adults ≥40 years with CVD risk who report moderate or high adherence (MARS-5 scale 16+) to statins and anti-hypertensive medications. Secondary outcomes were blood pressure control below 140/90mmHg and reduction in systolic blood pressure among participants with hypertension. Measurements were taken at baseline and the end of trial using cross-sectional surveys. Intervention impacts were estimated using generalized linear mixed models.
Results: Among 1,013 individuals screened, 392 had CVD risk factors. Of these, most were 65 years or older (58%), poor (85% in lowest 2 national quintiles), and many (44%) reported at least one disability; 11% were taking and adherent to medications at baseline. Adherence at the end of trial was 83% and 22% in intervention and control villages, respectively; this represents a treatment effect of 62 percentage points (risk ratio 2.96, p<0.001). Among participants in the VHW care model with hypertension, 80% achieved blood pressure control (RR 1.8 vs. control, p<0.004) and mean systolic blood pressure decreased by 22 mmHg (15.8 mmHg larger decrease vs. control, p<0.001).
Conclusion: A decentralized VHW-led care model dramatically increased coverage and utilization of evidence-based treatments for hypertension and CVD risk in remote conflicted-affected areas of Myanmar.
Keywords: Cardiovascular disease (CVD), Community Health Worker (CHW), Armed conflict
Poster Slot
D02
13:15 - 13:30
Community-Based Social Prescribing for Diabetes in a Super-Aged Snowbound Japanese City: Pilot Evaluation
| Presenter | : | Yugo Shobugawa |
| Abstract ID | : | A230 |
Background Rural Japan’s super-aged and depopulation have concentrated specialist care in cities, eroding access and control of non-communicable diseases. Tokamachi City—a mountainous, heavy-snow region with an ageing rate of 41 %—shows a cerebrovascular standardized mortality ratio of ≈ 1.3, partly reflecting sub-optimal diabetes management.
Objective To determine whether a link-worker-mediated social-prescribing model can improve glycaemic outcomes and serve as a sustainable, community-driven health-promotion strategy.
Methods Adults with type 2 diabetes attending the general hospital were referred during routine visits to a link worker. After holistic assessment, each participant received a tailored prescription: (1) supervised exercise therapy at a local facility and (2) individual nutrition counselling by a registered dietitian, both free of charge. Link workers provided motivational follow-up calls about monthly for three months. Primary endpoints were programme retention, body weight, and HbA1c; semi-structured interviews explored determinants of adherence.
Results Ten patients were enrolled (mean age 57.5 years; 30% female), and 8 (80%) completed the program. Patients who completed the program experienced a significant reduction in HbA1c levels from 8.4 ± 1.6% to 7.3 ± 0.7% without any changes in medication (p = 0.03). Additionally, body weight decreased slightly from 73.2 ± 23.2 kg to 72.6 ± 23.8 kg, but this change was not statistically significant. In interviews, four adherence-promoting factors were identified: (i) appropriate coordination and smooth referral from the hospital to community resources, (ii) ongoing motivational support from link workers, (iii) interventions addressing social determinants of health, and (iv) economic incentives such as free classes or counseling.
Implications Rural social prescribing leveraged existing community resources to rapidly improve diabetes control, indicating a scalable, low-cost response to demographic shifts. By expanding social resources, institutionalizing link-worker roles, and fostering clinical uptake, this model could bolster resilience in Japan’s super-aged society. It is now being scaled under the Ministry of Education’s RISTEX programme.
Poster Slot
E02
13:30 - 13:45
Implementation Research on Supportive Supervision Adoption for Community Health Workers (CHWs) in Indonesia: Community-Based Strategies for People-Centered Long-Term Care
| Presenter | : | Alhaynurika Nevyla Putri |
| Abstract ID | : | A231 |
Background: To address the growing Indonesian elderly population, the MoH launched an Integrated Primary Healthcare model, which tasks CHWs with supporting the delivery of a life-cycle approach to long-term care at Posyandu (village-based health posts). However, CHWs receive limited support for continuous learning due to limited resources, and health workers' limited availability and excess workloads. The PN PRIMA program bridges this gap by deploying trained supervisors (health professionals) to 38 Posyandus in two districts for 12 months. These supervisors strengthen CHW capacity to meet the MoH’s 25 competency targets through monthly group mentoring, one-on-one coaching, and WhatsApp-based technical assistance.
Methods: To accelerate adoption, we identified delivery gaps using implementation research principles. In the six-month midline and twelve-months endline assessments, we explored the implementation outcome domains (Proctor et al., 2011). Data were collected through 24 FGDs with 120 CHWs, 86 IDIs with service users, and pre–post observations using checklists in 12 Posyandus.
Results: The study found high acceptability among CHWs, who valued the Supportive Supervision for its flexible, responsive, and continuous learning opportunities. The program was considered appropriately-designed for lay persons of middle to older age. Perceived feasibility varies considerably in terms of time availability for participating in mentoring activities. CHW’s fidelity to most service standards improved gradually. CHWs completed 9 of 10 screening steps independently, with 8 done according to SOP. Nevertheless, health education and counselling remained a key challenge and largely linked to CHWs’ varying levels of confidence. Complex formats and long queues were also a challenge for completing health recordings.
Conclusion: Supportive supervision is critical for CHWs to meet service standards and achieve the MoH’s 25-competency target. To improve outcomes and ensure program adoption, we recommend closing supervision gaps by appointing dedicated CHW supervisors or equipping Posyandu coordinators at sub-district and village levels to take on supervisory roles.
Poster Slot
A03
13:30 - 13:45
Integrated Elderly Care in Sri Lanka: Mapping Services, Human Resources, and Policy Pathways
| Presenter | : | Uthpala Muhandiram |
| Abstract ID | : | A156 |
Population of Sri Lanka is reporting significant demographic changes with projections of one in four citizens will be age 60 years or above by 2040. To meet the growing needs of older people and achieve Universal Health Coverage, existing services and human resources need to be reformed. An objective of this abstract outline the protocol used to identify and map key elements of elderly care services and re-engineer them into an integrated care service delivery model. A sequential mixed-method design was employed, starting with a comprehensive review of policies, guidelines, and literature. This was followed by Focus Group Discussions and Key Informant Interviews with experts, service providers, and older adults. Qualitative data was analyzed using thematic analysis. Review and qualitative data were triangulated to map services and human resources, followed by an iterative process to re-engineer these elements into an integrated care model for older people.
Key elements/components of service delivery, include social and economic support, primary healthcare, a continuum of care (secondary, tertiary, intermediate, palliative, and long-term), age-friendly environments, and policies/legal frameworks. Healthcare and social services for older persons were mapped, followed by an assessment of current landscape of human resources. Care pathways were developed to address the diverse needs of older people. Key actions areas for implementing the model were identified. In conclusion, an integrated care for older people can be achieved through system re-engineering. A pilot of the proposed model is recommended to evaluate effectiveness before scaling up implementation. Care pathways for older people addressing diverse needs, with key implementation actions were identified. A pilot is recommended to evaluate the model's effectiveness before implementation.
Keywords: Universal Health Coverage, Integrated Service Delivery Model, Integrated Care Pathways
Themes: Primary Health Care
Poster Slot
B03
Vulnerable Populations and Equitable Access to Care
13:30 - 13:45
Human-Centered Design for Gender-Responsive Maternal and Child Health Long-Term Care in Indonesia
| Presenter | : | Rayssa Anggraeni Putri |
| Abstract ID | : | A164 |
Background
Women in Indonesia face intersecting barriers, including limited decision-making power, financial dependency, and restricted mobility for healthcare access. Lack of detailed mapping and understanding of these vulnerabilities hinders the development of targeted and equitable health interventions. Research on the demand-side needs of vulnerable populations in accessing health services in Indonesia remains limited. Addressing these gaps is essential to advancing inclusive and responsive service delivery for changing health needs.
Method
A human-centered design approach developed by Pathways (Johnson & Wendland, 2022) was applied to stratify and better understand the population according to the biopsychosocial vulnerabilities associated with maternal and child health outcomes in Indonesia. Using a pre-established segmentation framework, we conducted qualitative research between 2023–2024 to gather insights from women in 6 different household segments in four districts: Pidie, Garut, Badung, and West Sumbawa. In-depth interviews with 120 women and 57 healthcare providers informed the analysis of six gender-related themes to identify needs and tailor solutions for greater relevant impact.
Result
Each segment’s vulnerability profile remains the same across the districts despite cultural and environmental variations. R1-I (Rural) and U1-I (Urban), the least vulnerable, have strong health understanding, preference for formal care, and moderate-to-high digital access, though R1-I faces some access barriers. U2-I (less vulnerable) often lacks partner support, causing delayed care despite a preference for formal providers and moderate digital use. R3-I (more vulnerable) has low risk perception, mixed care-seeking patterns, and low digital behavior. U4-I and R4-I (most vulnerable), focuses on ever-married women facing time poverty, economic stress, limited digital access, and community stigma. Preference is towards informal care.
Conclusion
Understanding women’s vulnerabilities to health outcomes in Indonesia enables the design of more effective, targeted care. Differences in digital access, health barriers, and mental health profiles should inform policymakers and program designers in creating tailored health solutions.
Poster Slot
C03
13:30 - 13:45
Predictive Governance of Transit Migration and Internal Displacement in Mozambique: Bayesian and Agent-Based Modeling of Climate, Conflict and Demographic Shifts (2025–2040)
| Presenter | : | Elvino Zacarias Nhantumbo |
| Abstract ID | : | A066 |
Mozambique is a key transit migration corridor in Southern Africa due to its strategic location, porous borders, and limited institutional capacity for migration management. Simultaneously, it faces overlapping crises—mainly climate disasters and armed conflict in provinces like Cabo Delgado—that drive internal displacement. Despite these dynamics, national statistics inadequately capture transit migration and displacement. Key surveys such as the Demographic and Health Survey (DHS), Labour Force Survey (LFS), and Household Budget Survey (HBS) lack migration modules, and the decennial census omits causes of mobility. This study addresses these gaps by applying advanced quantitative methods to produce predictive scenarios (2025–2040) for mobility governance. Models include Bayesian hierarchical and spatial models, latent transit-state models, vector autoregressive (VAR), Bayesian VAR (BVAR), and agent-based models (ABM). Bootstrap and jackknife resampling validate the models. Using multisource data—from UNHCR, IOM, UN DESA, academic repositories, and climate satellite indices—the research examines pressures from transit migrants and internally displaced persons in provinces such as Cabo Delgado, Nampula, Sofala, Manica, and Gaza. It advocates integrating datasets via the National Institute of Statistics (INE) to overcome data gaps. Comparisons with Sudan, Niger, Burkina Faso, Democratic Republic of Congo, Bangladesh, Myanmar, and Haiti reveal shared governance challenges in fragile, data-poor contexts. Following the March 2025 UN revision recognizing temporary mobility (under 12 months), the study stresses national implementation. As IOM Deputy Director Ugochi Daniels stated at the 4th International Forum on Migration Statistics, “These revised recommendations provide a robust normative framework, but their true value depends on implementation.” The 2021 UN guideline defining habitual residence as 6 months plus 1 day is also noted, as many undocumented migrants exceed this. By modeling diverse transit and displacement scenarios, this research offers evidence-based insights to improve migration governance, resilience, and inclusive data strategies aligned with global frameworks.
Poster Slot
D03
13:30 - 13:45
Bridging the Gap: Integrating Nutrition and Health Equity for Indigenous Youth in Indonesia–Malaysia Border Regions
| Presenter | : | Agus Fitriangga |
| Abstract ID | : | A068 |
Background:
Indigenous youth in border regions face unique and persistent health inequities due to geographic isolation, socio-political marginalization, and limited access to essential services. In the Indonesia–Malaysia border area of Entikong, West Kalimantan, Dayak Bidayuh communities experience high rates of child malnutrition and poor health literacy. Despite multiple national and regional interventions, disparities remain. This study explores integrated community-based approaches to address structural determinants of health among indigenous youth in this transboundary context.
Methods:
We used a mixed-methods approach. A cross-sectional household survey (n=450 children under 18) assessed nutritional status using e-PPGBM surveillance data (2022–2024) and anthropometric measurements (WAZ, HAZ, WHZ). We conducted multivariable logistic regression to identify predictors of malnutrition. Qualitatively, we conducted 30 in-depth interviews and 6 focus group discussions with adolescents, parents, community leaders, and health workers. Thematic analysis followed Braun and Clarke's framework, identifying cultural, institutional, and environmental drivers of nutritional disparities.
Results:
Quantitative analysis revealed a 39.2% prevalence of stunting and 18.5% underweight among indigenous children, with maternal education (aOR: 2.91; 95% CI: 1.82–4.64) and household food insecurity (aOR: 3.26; 95% CI: 2.04–5.18) as significant predictors. Qualitative findings highlighted loss of indigenous food systems, distrust in state-led programs, and youth disengagement from health services. However, strong community cohesion and local knowledge offered entry points for co-designed interventions. Youth participants proposed culturally adapted nutrition education, mobile health outreach, and intergenerational knowledge sharing as feasible solutions.
Conclusion:
Integrating indigenous perspectives and empowering youth in co-creating health strategies can bridge long-standing equity gaps in border regions. Our findings support a paradigm shift from top-down to community-led multisectoral interventions. These results inform both Indonesian and ASEAN regional policy discussions on health equity, indigenous inclusion, and demographic transitions in peripheral geographies.
Poster Slot
E03
13:45 - 14:00
A Mixed-Methods Study of Vaccine Financing on the Thai-Myanmar Border: Quantifying Gaps and Explaining Barriers in Five Thai Provinces and Adjacent Myanmar States/Region
| Presenter | : | Nyein Chan Oo |
| Abstract ID | : | A130 |
The Thai–Myanmar border hosts more than 4.1 million migrants and displaced persons, creating one of Southeast Asia’s most complex immunization environments. Political instability, protracted conflict, and sustained mobility have contributed to sharply reduced vaccination coverage on both sides of the border. Preliminary estimates show that full vaccination coverage among children aged 0–4 remains critically low—17.5% in five Thai border provinces and 14.3% across adjacent Myanmar states. Myanmar’s 0–4 population is also substantially larger, and Thai service data likely reflect only the visible portion of the true migrant child population.
This study used a sequential mixed-methods design. Quantitative estimates combined MOI, MOE, IOM, and census data with the Proportion–Inverse Proportion (PIP) method to estimate unregistered children, and calculated vaccine demand and costs using Thai NHSO, Gavi, and NGO delivery models. Qualitative data from stakeholder consultations examined delivery bottlenecks, financing constraints, and systemic barriers. Findings reveal significant financing requirements: 93 million THB for vaccines in the five Thai provinces, compared with 210–480 million THB for Myanmar’s ECBHO-managed areas and 1,480–3,045 million THB for the full five Myanmar states. Barriers include fragmented records, fear-driven access constraints, chronic under-investment, and overburdened frontline workers.
To address these gaps, the study proposes four policy actions: (1) formalize Thai-side financing through expanded NHSO coverage or a pooled Humanitarian Health Fund; (2) access lower-cost vaccines via Gavi-price mechanisms or manufacturer agreements; (3) strengthen delivery systems through proactive outreach, school-based vaccination, and structured cross-border partnerships; and (4) improve system capacity with mobile/offline tracking, stronger cold chain, and recognition of Myanmar health workers.
Cross-border immunization gaps pose urgent regional health-security risks. Scalable financing, strengthened delivery systems, and coordinated binational action are essential to reduce zero-dose burden and protect mobile, stateless, and conflict-affected children.
Poster Slot
A04
13:45 - 14:00
Adapting health systems to respond to refugees’ health needs: new empirical evidence on the integration of refugees into national health systems in LMICs
| Presenter | : | Maria Bertone |
| Abstract ID | : | A106 |
Approaches to delivering health services to refugees, especially in emergency situations, have relied on the establishment of mechanisms parallel to the national health system. With rising numbers of refugees globally, prolonged displacement and reduced funding, the global consensus is to move away from parallel approaches that are potentially inefficient and unsustainable to focus on the inclusion of refugees in national health systems and on the integration of health systems. The Global Compact for Refugees (GCR), endorsed by 181 countries, calls for facilitating access to healthcare services by refugees and host communities by expanding and enhancing the quality of national health systems, building and equipping health facilities and strengthening services. However, there is still limited empirical analysis of how to adapt healthcare responses and service delivery for refugees’ health needs, and none as yet with a comparative perspective.
This presentation synthesises evidence drawing from a large, comparative mixed-methods research focusing on six low- and middle-income settings (Kenya, Kurdistan Region of Iraq, Mauritania, Pakistan, Peru and Zambia) commissioned by UNHCR. While a shift towards health system integration and the inclusion of refugees in national health systems is the normative pathway highlighted in the global strategic documents, our work provides insights on how the health system integration process is managed at country level and on the contextual drivers and timing of policy and practice changes in healthcare response for refugees. The study also provides an analytical synthesis of the approaches adopted in each setting, and reflects on the challenges, lessons learned and potential entry points for ensuring effective and equitable health system integration. The findings are essential to guide policy and practice at country level and by international organisations to adapt service delivery and respond to the shifting health needs of refugees and host communities alike.
Poster Slot
B04
13:45 - 14:00
Examining the state of the Indian health system’s responsiveness to the most-in-need and most vulnerable older people
| Presenter | : | Thi Vinh Nguyen |
| Abstract ID | : | A152 |
Responsiveness is recognised as one of the goals of all health systems. It relates to the non-medical aspects of the care encounter across six key domains: promptness of attention, upholdment of dignity, communication, maintenance of confidentiality, choice of providers, and quality of amenities. We argue that a good test of whether a health system is meeting this goal for older persons is to see how it performs for the most-in-need and most vulnerable amongst them.
We analysed data from the nationally representative Longitudinal Aging Study (Wave 1) in India to assess the state of the Indian health system’s ‘responsiveness’ to the most-in-need and most vulnerable older people. We found that most-in-need older people, i.e., those with functional limitations, including difficulties with activities of daily living or instrumental activities of daily living, were more likely to experience poor responsiveness. For inpatient care, poorer ratings were observed across five of the six domains of responsiveness. Those with multiple chronic diseases (multimorbidity) were more likely to report poor responsiveness in prompt attention and communication for outpatient settings.
Among individuals with functional limitations, those from the lowest castes i.e., those most socially marginalised and vulnerable, reported poorer experiences in quality of amenities for outpatient care, and in choice of providers and quality of amenities for inpatient care. Similarly, those from lower wealth quintiles, i.e., those most financially vulnerable, reported poorer experiences in confidentiality for outpatient care and in quality of amenities for inpatient care.
Our analysis highlights the need for health systems in economies in transition to be more responsive to the complex needs of older people, especially those with functional limitations and multimorbidity and those from socially disadvantaged backgrounds. Addressing these gaps is critical for equitably improving healthcare experiences and outcomes for India’s rapidly ageing population.
Poster Slot
C04
13:45 - 14:00
Climate-Induced Displacement, Urban Poverty, and Neglected Primary Healthcare: Exploring Financing Barriers and Service Access for Displaced Communities in Bangladesh
| Presenter | : | Mahbubur Rashid Ories |
| Abstract ID | : | A171 |
Bangladesh exhibits some of the highest rates of climate-induced internal displacement worldwide, as riverbank erosion forces thousands into informal urban settlements annually. Displaced populations encounter multiple vulnerabilities, including loss of livelihoods, insecure housing, and systemic exclusion from primary healthcare systems. This research investigates the impact of displacement on health risks, access to services, and financial barriers, with the goal of identifying equitable and scalable solutions. A cross-sectional, mixed-methods design was conducted in five major urban centers: Dhaka, Gazipur, Chandpur, Feni, and Noakhali. The data collection process comprised household surveys (n=300), focus group discussions, and key informant interviews involving healthcare providers, NGO workers, community leaders, microfinance representatives, and policymakers. The analysis utilized the Knowledge, Attitudes, and Practices (KAP) framework, in conjunction with the Health Access and Financial Risk Protection and Sustainable Livelihoods frameworks. The findings indicate that 45% of households reported abnormal health conditions, characterized by a high prevalence of chronic illnesses, reproductive health issues, and untreated mental stress. Only 20% utilized government hospitals, whereas the majority depended on satellite clinics (55%) or NGOs (35%) due to factors such as cost, distance, and identification requirements. Monthly out-of-pocket expenditures frequently surpassed BDT 5,000, compelling 30% of households to engage in borrowing or asset liquidation. Women encountered further obstacles to obtaining gynecological care, while children were unable to receive routine vaccinations due to issues related to affordability and access. The study advocates for reforms in primary health care that are responsive to displacement, such as the implementation of mobile digital health units, community health fellowships, mobile health wallets, one-stop health kiosks, and integrated health-legal aid services. The proposals correspond with PMAC 2026’s sub-theme regarding sustainable financing and health system transformation, providing policy-ready models for equitable urban health in contexts affected by climate change.
Poster Slot
D04
13:45 - 14:00
Unpacking the Progress towards Universal Health Coverage (UHC): Financial Protection Insights and Analytics from the Western Pacific
| Presenter | : | Alia Cynthia Luz |
| Abstract ID | : | A219 |
Many people in the Western Pacific, especially poor, older, and vulnerable populations, have historically struggled with unaffordable healthcare costs. Catastrophic health spending (the proportion of households in the population spending at least 10% of their budget on health) is the official indicator to measure financial protection (FP), which is a core UHC tenet. A WHO regional report on FP highlighted that, in 2017, one in five households had catastrophic health spending. In at least three countries, over 20% of households with older persons incurred catastrophic spending.
However, the report also highlighted that, on average, those in the poorest quintile spent less than 10% of their household budget on health, implying that the most vulnerable households more likely to be affected with financial hardship could be underrepresented in the estimates. This highlights limitations of the current indicator, including overcounting households in higher income quintiles that can afford to spend more on healthcare.
In 2025, the UN Inter-Agency and Expert Group on SDG Indicators revised the official indicator’s methodology to measure the share of the population incurring financial hardship due to both large and impoverishing out-of-pocket health spending. The revision is intended to be more sensitive to spending at the lowest quintiles and would likely impact the estimates for other socioeconomic indicators. The WHO Western Pacific Regional Office will be analyzing the new estimates, especially to understand the drivers of financial hardship and implications to these populations of interest.
There results have clear inputs to policy, especially as a call to action to explore solutions and mobilize effective responses in the Asia-Pacific context where countries are experiencing demographic transitions such as rapidly ageing populations, macrofiscal and economic constraints in the wake of COVID-19 and shrinking ODA, growing health burdens such as NCDs and health security threats, and existing challenges within healthcare systems.
Poster Slot
E04
Friday 30 January 2026
Digital Health and Technological Innovation
10:00 - 10:15
Determinants of ICT Acceptance Among Elderly People in Japan: Insights for Promoting Decentralized Personal Data Management Applications
| Presenter | : | Ikuko Tsumura |
| Abstract ID | : | A033 |
In ageing societies such as Japan, digital health technologies are expected to reduce the burden on care systems. However, elderly people often remain reluctant to adopt new technologies, and the underlying reasons are not fully understood.
Since 2021, the Decentralized Big Data Team at RIKEN AIP has conducted a pilot project in Minami-Alps City involving a smartphone-based personal data (PD) application designed to support health monitoring for older adults. The PD app enables users to securely manage their data in a decentralized manner and voluntarily share it when needed. Despite the potential benefits, a 2022 survey showed low usage rates among older participants, limiting further analysis.
To investigate the determinants of ICT acceptance, we conducted a web-based survey among 700 smartphone users aged 60 and above in Japan, using the widely adopted messaging app LINE as a case study. We examined: (1) age-related differences in reasons for non-use, particularly privacy concerns, and (2) reactions to being prompted to register for LINE while shopping.
Among 94 non-users, 30.9% cited privacy concerns, surpassing the 19.1% who reported usability issues. Privacy concerns were more common among those aged 60–69 (42.9%) than among those 70 and older (17.8%).Among current users who were asked whether they would register when prompted while shopping, 43.9% (n = 266) refused, and 53.8% of these respondents cited privacy as their primary concern. This suggests that strengthening privacy protections may help increase registration rates. Among those who agreed to register (24.9%, n = 151), 76.8% also selected privacy concerns. These results show that implementing effective privacy safeguards is crucial when introducing new IT tools.
These findings highlight privacy concerns as a major barrier to ICT adoption in older populations. The observed generational differences may inform future strategies for expanding the use of decentralized data applications in ageing societies.
Poster Slot
A05
10:00 - 10:15
A Conceptual Framework for Global Health Security under the Pandemic Agreement: from a lens of AIxBio
| Presenter | : | Yi Cai |
| Abstract ID | : | A052 |
The use of Artificial Intelligence (AI) for Research and Development (R&D) in all areas of
biotechnology (AIxBio) has rapidly advanced in recent decades especially during the COVID-19
pandemic. Developing countries have made significant contributions through biological genetic
resources (i.e., pathogens) sharing for the R&D of AIxBio; however, a lack of benefits (i.e., COVID-
19 vaccines) sharing were received. Thus, establishing a Pathogen Access and Benefits Sharing
(PABS) system in the Pandemic Agreement could be the solution for encouraging both sharings of
pathogens and benefits. In our study, we proposed a conceptual framework for assessing global
health security capacities with the consideration of the development and implementation of the
PABS system. We conducted a content analysis of online government documents and press releases
in China to propose the initial version of the framework; and then applied a comparative analysis
with previous toolkits such as Global Health Security Index, Joint External Evaluation, and Oxford
COVID-19 Government Response Tracker to add components due to diversities of institutional
arrangements and cultural customs across the world; at last, we used panel discussions for
converging the domains and themes. Finally, we proposed a conceptual framework with four
domains: 1) vertical and horizontal coordination governance; 2) risk assessment, vulnerability and
resilience; 3) pandemic prevention, preparedness, response and recovery; 4) risk communication
and community engagement. In each domain, there are key themes identified for achieving global
solidarity and equity, such as global governance with the consideration of common but differentiated
responsibility by all stakeholders, whole-of-government approach at national and sub-national level
focusing on themes of supply chain and logistics, education and small business, risk assessment for
measuring vulnerability and resilience at global, national, health system and community levels,
pathogen surveillance and sequencing for preventing pandemic, as well as enhancing risk
communication and community engagement by mutual learning of best practices.
Poster Slot
B05
10:00 - 10:15
Assessing the Value of Future Technologies for Health, Justice and Planet
| Presenter | : | Kanchan Mukherjee |
| Abstract ID | : | A095 |
There has been tremendous technological innovation in the healthcare sector, especially in the application of AI and digital technologies, which have emerged as the ‘new normal’. With the demographic shift and increase in elderly population, home based care and remote monitoring of patients is increasingly being dependent on such technologies. However, the use of these health technologies has also raised serious ethical and social concerns. Also, not all healthcare technologies add value or are sustainable. Hence, sustainable healthcare technologies must be identified early, adapted contextually, and scaled up effectively by policy makers, to meet the healthcare needs of society without compromising the principles of justice and equity. Given the complex interactions between health technology and policy, coupled with an uncertain future, policymakers are faced with tough decisions. In this context, this research discusses the emerging question of how science can help in this decision making in the evolving ‘new normal’.
To answer this question, the study used inductive epistemology and applied the principles of pragmatism and historicity to explore the role of two existing scientific mechanisms, Health Technology Assessment (HTA) and Responsible Innovation in Health (RIH), as a source of evidence in policies regulating the emergence and use of innovative health technologies. Using inductive epistemology, the linkages between HTA and RIH within a health innovation
ecosystem framework is analysed for the future application of an integrated approach to address societal challenges. The study findings resulted in the creation of an integrated model conceptualized as transdisciplinary, flexible, and adaptive, and expected to facilitate future research and policy action.
Poster Slot
C05
10:00 - 10:15
Adapting the Public Health Workforce for Digital Health: Aligning Education with Labour Market Needs
| Presenter | : | Li Han Wong |
| Abstract ID | : | A122 |
Background:
Digital technologies—from electronic health records and telemedicine to artificial intelligence—are fundamentally reshaping public health practice and governance. The COVID-19 pandemic accelerated this transformation, emphasizing the urgent need for a digitally proficient public health workforce. Despite global strategies like the WHO’s Global Strategy on Digital Health 2020–2025, little is known about how effectively current public health education prepares students to meet labour market demands for digital competencies.
Methods:
This study employed a mixed-methods approach to bridge this knowledge gap. We conducted focus groups with over 100 students from five European Schools of Public Health, supplemented by a validation workshop with more than 20 residents, to explore their understanding of digital health, exposure during training, and perceived competency needs. In parallel, 800 global job vacancies labeled “digital health” were coded and analyzed for required skills, job roles, sectors, and geographic distribution.
Results:
Students reported strong interest in digital health but inconsistent curricular exposure, with core content on AI, health data systems, or innovation frameworks often absent from required courses. Both students and residents highlighted systemic barriers including outdated infrastructure and limited faculty literacy. Key digital competencies identified as essential included digital literacy, applied data skills, cross-disciplinary collaboration, and the ability to lead or support digital transformation. Labour market analysis revealed consistent employer demand for collaboration, hands-on experience with digital systems, governance, evaluation skills, and emerging hybrid roles—such as digital health advisors and data-driven strategists—primarily in North America and Western Europe.
Conclusion:
Findings confirm a persistent misalignment between education and workplace needs for digital health. We recommend embedding digital health competencies throughout the public health curriculum, investing in faculty development, expanding experiential learning, and fostering cross-sector partnerships. Modernizing education pipelines in these ways will foster a digitally competent workforce able to drive transformative change in 21st-century health systems.
Poster Slot
D05
10:00 - 10:15
Cross Border Digital Initiative in support of migrants on the move Across Asia–Pacific
| Presenter | : | Sunny Ibeneme |
| Abstract ID | : | A176 |
International organizations including UNICEF, WHO and GAVI etc., are extremely worried about the resurgence of Vaccine Preventable Diseases across Asia–Pacific. In a recent joint WHO/UNICEF/GAVI press release, the agencies noted the resurgence of Polio, Cholera and Measles outbreaks in the Asia–Pacific region noting that these outbreaks would threaten years of progress.
There are concerns for both the safety of thousands of unvaccinated children moving across the region, and for that of the local populations with whom they interact. Thus, in collaboration with governments, UNICEF aligns efforts with Partners on varied cross-border digital health initiatives for migrants on the move. While most tools are matured and well-developed, others are evolving tools with opportunities to serve as interim solutions to connect/integrate available governmental datasets and registries.
Myanmar is a good example where citizens vaccinated in camps might never be cross-referenced or validated by their own government. Thus, interim solutions can assist with population movement to track vaccination status, offer mobile and fixed-site services, keeping individuals' vaccine-protected, thereby reducing risks to self and others.
In collaboration with governments, UNICEF supported countries to develop a virtual vaccination or Digital Health Card (The LACPASS) for children, as it is very difficult for migrant parents to keep paper documents while on the move. This initiative, which started as a digital COVID-19 certificate, has overtime been expanded to cover all immunization records and the entire International Patient Summary.
Our presentation will showcase a UNICEF use-case of LACPASS, as well as a government-led participatory GIS local-level mapping tool that identifies migrants’ cross-borders crossings. Using GIS, satellite imagery and participatory mapping tools, our session will demonstrate the use of spatial technologies to map-out unofficial border crossing and consequently identify settlements near informal border crossing where targeted services could be directed.
Poster Slot
E05
10:15 - 10:30
Harnessing AI for Climate-Health Resilience: Developing a Community-Centric Heat Action Plan in Assam, India
| Presenter | : | Aashi Srivastava |
| Abstract ID | : | A206 |
Heatwaves are among the deadliest and fastest-growing climate risks worldwide, affecting over 1.2 billion people between 2000 and 2019. Their frequency and severity have risen by more than 50% over the past five decades, with South Asia emerging as a hotspot. Unlike rapid-onset disasters such as floods or cyclones, heatwaves are a slow-onset hazard that often escapes attention until their health, economic, and social impacts become acute.
In 2024, India recorded 733 heatstroke deaths and 40,000 cases across 17 states, underscoring the national scale of the crisis. Assam, traditionally a humid and flood-prone state, is now experiencing rises in LSTs, leading to reduced agricultural productivity, increasing heatstroke incidence, and straining public health systems. In urban centers, where the urban heat island effect has pushed "feels-like" temperatures beyond 55°C, endangering vulnerable populations.
While India’s policy framework, guided by the National Disaster Management Authority (NDMA), has prompted several states to adopt Heat Action Plans (HAPs), Assam still lacks a dedicated Heat Action Plan and hyperlocal early warning systems.
This abstract presents a policy development and implementation case on Assam’s first HAP, designed to bridge these gaps. We hypothesize that a data-informed, multi-stakeholder HAP, enabled by a central data ecosystem (IDS-DRR) and a citizen-centric chatbot can improve heat-related health outcomes and community preparedness. The chatbot links official data with on-the-ground public action, delivering timely warnings and heat-health guidance.
We are supporting the Assam State Disaster Management Authority (ASDMA) in co-designing the state’s first HAP, fostering collaboration between government agencies, technical experts, and local communities. This integrated approach strengthens public health outcomes while offering a scalable and equitable model for other regions. By showcasing this case, we contribute to the conference themes, demonstrating how transformative governance can leverage technology and community engagement to address climate risks and build long-term global health resilience.
Poster Slot
A06
10:15 - 10:30
Co-Creating Health Futures: Youth Leadership in Digital Health & Data Governance
| Presenter | : | Whitney Gray |
| Abstract ID | : | A222 |
The Digital Transformations for Health Lab (DTH-Lab) positions young people as active partners, not passive beneficiaries, in shaping digital health governance. Through four interconnected workstreams: co-designing digital first health systems (DFHS), advancing value-based digital and data governance, addressing digital determinants of health, and promoting digital citizenship for health, young leaders co-develop solutions that translate their health priorities into actionable policies and practices.
Between 2024 and 2025, DTH-Lab engaged over 300 young people from 80 countries in regional workshops and focus group discussions. Using participatory and co-creation methods such as design sprints, stakeholder role-play, and foresight exercises, youth generated context-specific, rights-based recommendations for inclusive and equitable digital health systems. Young people expressed increasing concern over health issues, including mental health, sexual and reproductive health, and climate-related health risks, alongside calls for inclusive digital ecosystems rooted in equity, trust, ethics, humanism, accountability, and inclusion. By embedding youth voices within systems design and governance processes, DTH-Lab seeks to ensure that current and emerging digital health solutions respond to real-world challenges across geographies and identities for young people, as there is “Nothing about them, without them.”
DTH-Lab’s multifaceted ecosystem of meaningful engagement, through the #MyHealthFutures Youth Network, Regional Youth Champions, Research Fellowships, and partnerships with youth-led organizations, demonstrates the transformative potential of co-creation. These participatory mechanisms are not add-ons; rather, by including youth as key stakeholders, they become central to building legitimacy, trust, and sustained impact.
This presentation will showcase DTH-Lab’s participatory engagement model, highlighting how co-creating with youth contributes to more relevant, inclusive, and equitable governance solutions. It will spotlight the role of youth leadership at the intersection of health, gender, and the environment, where intersecting inequities require innovative,rights-based approaches. It will also share lessons on meaningfully and strategically integrating youth leadership into decision-making processes in the digital health ecosystem. By illustrating the tangible impact of meaningful youth participation, this presentation will equip stakeholders with practical, tested frameworks to embed intergenerational collaboration in their digital health governance contexts that enable the co-creation of a more just, inclusive, and future-ready health system.
Poster Slot
B06
Demographic Transition and Economic Development
10:15 - 10:30
Human capital-induced labor productivity growth and first demographic dividends in four Asian countries
| Presenter | : | Yasuyuki Sawada |
| Abstract ID | : | A067 |
Can labor productivity growth from improvements in the health of the population and educational attainment attenuate the expected economic decline from population ageing? We address this question by combining national-level age-based estimates of the economic life cycle, population health, and schooling in a growth accounting framework applied to four Asian countries, namely Japan, Malaysia, the Philippines, and Thailand. The results of the decomposition analysis show that human capital-induced labor productivity growth has significantly contributed to the income growth of these countries over the last three decades, which was more than enough to offset the negative growth from population ageing in Japan and Thailand. However, we document that labor productivity growth from the expansion of human capital has been waning in the three Southeast Asian nations. We also find a perverse association between human capital expansion and labor force participation rates, potentially indicating misallocation of human resources in these countries. While economic growth from raising human capital may be enough to address a potential economic decline due to population ageing in the future, poorer countries may need to look for growth elsewhere to propel them from the low-/middle-income trap to high-income status.
Poster Slot
C06
10:15 - 10:30
Myanmar's Two-Speed Demographic Transition: Evidence of Deep Educational and Geographic Divides
| Presenter | : | Zarni Lynn Kyaw |
| Abstract ID | : | A154 |
The 2014 Myanmar Census, the nation's first in three decades, provides a critical baseline for understanding its demographic transition. While national-level indicators suggest Myanmar is in a late stage of this transition, such averages mask profound internal inequalities crucial for equity-centered policymaking. This study utilizes the 10% census microdata sample (N=5,032,818) to move beyond aggregates and quantify these socio-economic and geographic divides.
Applying indirect estimation techniques (Relational Gompertz and Brass methods) and logistic regression modeling, the analysis first establishes national estimates for a period Total Fertility Rate (TFR) of 2.90 and an Under-Five Mortality Rate (U5MR) of 28.4 deaths per 1,000 live births. However, the core findings reveal a "two-speed" transition. Fertility is significantly higher in rural areas (TFR 3.05) than urban (2.46), and a steep educational gradient exists, with TFRs ranging from 3.21 for women with primary education to a below-replacement level of 1.88 for those with tertiary education.
These disparities are most critical in child survival. A logistic regression model demonstrates that the odds of child mortality are 1.94 times higher for children of mothers with primary education or less compared to those with tertiary education. Rural residence independently increases the odds of child death by 48% (OR=1.48).
This analysis underscores the power of microdata to identify high-risk subpopulations. The findings provide quantifiable evidence that investing in female education, particularly secondary school completion, and implementing targeted rural health initiatives are the most effective strategies for ensuring an equitable demographic future for all of Myanmar.
Poster Slot
D06
Climate Crisis and Health
10:15 - 10:30
Legal and regulatory mapping of policies and action plans addressing the intersection of heat with health, gender, and vulnerable populations.
| Presenter | : | Lynn Tang |
| Abstract ID | : | A082 |
Description:
As heat events become more frequent, prolonged, and intense, they are triggering a wide range of health, economic,
and social challenges. Heat exposure exacerbates existing vulnerabilities, especially those facing poverty, chronic illness,
and inadequate housing. These challenges are further compounded by rapid urbanization, changing land use, and
increased rural-to-urban migration which result from and intensify geopolitical tensions and demographic shifts. The
impacts of heat go beyond the immediate risks of heat exhaustion and heatstroke that reduce labor productivity,
increase absenteeism, and drive-up hospital admissions. Extreme heat can worsen air quality, increasing respiratory and
cardiovascular problems. Furthermore, hotter temperatures are responsible for declines in crop yields and food spoilage,
undermining food security by impacting access to nutritious food and disrupting rural livelihoods. Addressing these
overlapping risks requires coordinated, multisectoral action spanning health, agriculture, labor, and environmental
governance. This study presents a systematic mapping of current laws, regulations, policies, and action plans relevant to
heat and health in Thailand, Indonesia, and Vietnam. We catalogue the range of legal and policy tools in place and
examine how different agencies coordinate their response to the issue of heat and health. Special attention given to
assess provisions for protection (if any) of disproportionately affected groups, including women, children, the elderly,
and marginalized communities. Findings from this study will inform policymakers and donors by highlighting governance
strengths, gaps, and opportunities for improved integration of climate and health considerations across environment,
health, labor, and civil protection agencies. Ultimately, this supports targeted investment in health system resilience,
more equitable protection frameworks, and more coordinated, data-informed responses to the evolving threats of
extreme heat in Southeast Asia.
Poster Slot
E06
12:30 - 12:45
Youth Leadership Integrating Health into UNFCCC Climate Governance
| Presenter | : | Wing Tung Rachel Cheung |
| Abstract ID | : | A185 |
Background: The climate crisis is a health crisis. Youth leadership is essential to align climate policy with equity and planetary health. Recent UNFCCC cycles increasingly integrated health across core workstreams.
Objective: To develop and assess a youth-led, health-centred advocacy model spanning COP29 (Baku, 2024) and SB62 (Bonn, 2025), and to develop technology-enabled practices for equitable participation ahead of COP30.
Methods: Practice‑based case study using participant observation and activity logs. Components: hybrid delegation (n=20; 10 in‑person/10 online); three youth‑co‑hosted sessions at the WHO Health Pavilion; daily coordination with the health community; targeted tracking of Global Goal on Adaptation (GGA) indicators, finance, and just transition; a high‑visibility “Code Blue” action at SB62; and a five‑day Pre‑COP capacity‑building programme (>100 participants, >15 speakers) with a follow‑up kit. A post‑training poll captured outcomes.
Results: Three mechanisms enabled inclusive engagement: (1) hybrid participation broadened access (notably for LMIC youth) and sustained continuity between COP and SB sessions; (2) structured coordination (shared note‑taking, clear briefs, time‑bound asks) translated technical text into health‑centred advocacy, including on climate‑resilient health systems within GGA discussions; and (3) partnerships with youth and health networks increased speaking opportunities and message alignment on mental health and non-communicable diseases. Outputs included Health Pavilion events, daily cross‑organisation briefings, social‑media recaps, and outreach to Party delegations. The poll found 93.8% reported climate‑health gaps in curricula and >75% committed to reforms, suggesting a pipeline from advocacy to education. Challenges included accreditation/ finance, time zones/ connectivity, and continuity of work as rotating delegates across meetings complicate follow‑up and institutional memory.
Policy implications: Institutionalise hybrid youth engagement with equity safeguards; embed health and SRHR metrics in GGA and NAPs; dedicate adaptation finance to climate‑resilient health systems; integrate worker and community health within just transition; and formalise youth‑inclusive consultations, with continuity tools (living briefs, handovers, mentorship) across UNFCCC cycles.
Poster Slot
A07
Health System Resilience and Financing
12:30 - 12:45
From Fragmentation to Integration: Strengthening Primary Health Care Financing through Public Financial Management Reform in Indonesia
| Presenter | : | Feby Oldfisra |
| Abstract ID | : | A081 |
Indonesia’s demographic shifts marked by population aging, rising non-communicable diseases, and persistent geographic inequities are increasing demand for accessible and high-quality Primary Health Care (PHC). The government’s reforms under the 2023 Health Law and the 2024 PHC Implementation Regulation aim to strengthen service coverage and equity. However, the current PHC financing architecture remains fragmented, with multiple funding sources including the central budget, local government allocations, National Health Insurance (JKN) capitation and claims, and earmarked grants operating under different rules, timelines, and reporting systems. This fragmentation leads to misaligned resource allocation, low budget absorption, procurement delays, and limited responsiveness to evolving health needs. Financial and service delivery data are also managed on separate platforms, constraining transparency, performance monitoring, and evidence-based decision-making.
To address these challenges, a collaboration between the Ministry of Health and WHO was initiated from 2023 to 2025. The process included issue identification, technical assistance, and an analytical study, followed by review and policy dialogue to validate recommendations.
The study applied a mixed-methods design combining budget analysis, Data Envelopment Analysis, and stakeholder interviews to examine financing flows, budget processes, and oversight mechanisms in 12 Puskesmas across districts with diverse fiscal capacities, geographic contexts, and governance arrangements. These included both BLUD (Badan Layanan Umum Daerah) local public service entities granted flexibility to manage their own revenues and expenditures and non-BLUD Puskesmas that remain tied to rigid government budgeting rules.
Findings highlight that multiple funding streams create inefficiencies and limit adaptability, particularly in non-BLUD settings. The review identified actionable reforms including: (1) a “One Budget” approach; (2) front-loading disbursement; (3) harmonized fund-use and procurement rules; (4) unified reporting systems; and (5) financial management capacity building. These intermediate and long-term actions aim to improve PHC financing efficiency, flexibility, and accountability supporting health system transformation responsive to Indonesia’s demographic realities.
Poster Slot
C07
12:30 - 12:45
Expanding Urban Access through Private Sector Integration: Evaluation of the “30 Baht Treatment Anywhere” Policy in Thailand
| Presenter | : | Suchunya Aungkulanon |
| Abstract ID | : | A086 |
Background
Thailand’s health system faces persistent challenges from overcrowded public facilities and inequitable access in urban areas. In 2024, the “30 Baht Treatment Anywhere” policy enabled Universal Coverage (UC) patients to access primary care services beyond their registered catchment areas. A key innovation was the integration of private-sector clinics including medical, nursing, pharmacy, dental, rehabilitation, traditional Thai medicine, and laboratory services into the UC network to alleviate hospital congestion and expand primary care accessibility.
Methods
A retrospective analysis of National Health Security Office claim datasets (January 2023–May 2025) assessed clinic registration density, outpatient visit volumes, and “newcomer” patients (no UC use in the preceding three years). Interrupted Time Series (ITS) regression was used to evaluate temporal trends, and Moran’s I statistics assessed spatial utilization patterns.
Results
By June 2025, over 14,000 private clinics had joined the UC network, covering 93% of districts nationwide. In the first half of 2025, these clinics accounted for 12% of all outpatient visits nationally and 25% in Bangkok. ITS analysis showed no significant change in public hospital utilization for common illnesses post-policy (p > 0.05), indicating that service congestion in public hospitals goals remain unmet. The proportion of newcomers accessing private clinics was considerably higher in Bangkok (18%) and peri-urban provinces (9%) compared with rural and non-urban areas (2%). Spatial analysis revealed significant clustering of newcomer utilization within the Bangkok Metropolitan Region (p < 0.05). The proportion of newcomers accessing private clinics was considerably higher in Bangkok (18%) and peri-urban provinces (9%) compared with rural and non-urban areas (2%). Spatial analysis revealed significant clustering of newcomer utilization within the Bangkok Metropolitan Region (p < 0.05).
Discussion
Private-sector integration within Thailand’s UC network has expanded decentralized primary care delivery, improved geographic accessibility, and reached previously unreached urban populations. This model offers a scalable approach for strengthening urban health systems in other middle-income settings.
Poster Slot
D07
12:30 - 12:45
Lives in Transition: Responsive Health Service Delivery for Displaced and Conflict-Affected Communities in Myanmar
| Presenter | : | Han Win Htat |
| Abstract ID | : | A113 |
Lives in Transition: Responsive Health Service Delivery for Displaced and Conflict-Affected Communities in Myanmar
Background: Since the political crisis in 2021, conflicts and health-worker attrition fractured Myanmar’s health system, and violence worsened health risks for communities, including migrants and displaced people. In this context, SCH implemented a responsive health service delivery project in 2023, leveraging strategic purchasing through private clinics.
Methods: Observational implementation study (March–December 2023). Ten private clinics in ten conflict-affected townships across five states/regions delivered a context-adapted package to 10,426 enrollees. Utilization (unique users and total visits) was logged in KoBoToolbox and analyzed in Excel. Endline in-depth interviews (10 doctors, 10 assistants, 30 clients) underwent rapid thematic analysis. Township service data were spatially overlaid with 2023 ACLED violence-event and fatality counts. We derived township-level utilization shares and computed Pearson correlation coefficients between utilization share and the shares of total conflict events and fatalities.
Results: Among enrollees, 4,144 (40%) used their assigned clinics, generating 14,137 visits. Utilization among registrants ranged 23–57%, highest in Lashio (57%) and lowest in Hpa-An (23%). Conflict suppressed access: Shwebo held 24% of events/29% of fatalities yet only 5% of visits; Monywa 14%/15% with 9%. In lower-intensity Hpa-An (3%/2%) and Kawlin (2%/4%), utilization was higher (11%, 9%). Across townships, utilization share correlated negatively with conflict events (r=−0.44) and fatalities (r=−0.52), consistent with conflict-driven access constraints. Common illnesses accounted for 45% (6,350), NCDs 28% (4,025), and RMNCH 25% (3,470). Utilization spanned the life course (0–4 y 18%; 5-19 y 12%; 20–49 y 38%; ≥50 y 32%), reflected both pediatric demand and chronic-care needs. Delivery adaptations included multi-month dispensing, security-aware scheduling, and mobile outreach.
Conclusion: An adaptive, risk-informed strategic-purchasing model delivered responsive primary care amid insecurity by leveraging private clinics and flexible workforce adaptations. Bringing care closer to conflict-affected communities, aligning schedules with security windows, and pre-positioning chronic medicines preserved continuity and equity. The approach can be scaled across fragile settings.
Poster Slot
E07
12:45 - 13:00
AMRSense: A People-Centric, AI-Enabled Scorecard for Antimicrobial Resistance Stewardship and Surveillance in Karnataka, India
| Presenter | : | Tavpritesh Sethi |
| Abstract ID | : | A234 |
Antimicrobial resistance (AMR) poses a significant threat to the resilience of health systems, particularly in low- and middle-income countries (LMICs). Yet AMR surveillance and stewardship remain fragmented and largely hospital-centric, limiting community-level evidence on resistance trends, awareness, rational use of antimicrobials, and their relationship to hospital-based resistance.
AMRSense is a people-centric, AI-enabled, multisectoral ecosystem of tools and a scorecard designed to strengthen AMR surveillance and stewardship. Developed through a public–academic–implementation–industry partnership, AMRSense aligns with national digital health infrastructure and global AMR priorities.
The scorecard comprises four complementary pillars. First, community-level surveillance tools. A Delphi-validated, gamified, and culturally adapted tool has been co-designed for deployment by Accredited Social Health Activists (ASHAs). It integrates Ayushman Bharat Health Account (ABHA) IDs for a longitudinal understanding of community health journeys and utilizes AI to reduce data drudgery. Second, AMR awareness and behaviour change are catalyzed through gamification and social recognition. InfectionEscape, a serious game, was piloted during World Antimicrobial Awareness Week 2024, followed by expert-validated, AI-generated training videos for frontline workers and youth-focused digital engagement initiatives during World Antimicrobial Awareness Week 2025. Third, community-level resistance trends and antibiotic consumption patterns are assessed through pincode-level aggregated prescription and sales analytics. Fourth, intuitive visualizations and analytical tools translate routine surveillance and microbiology data into actionable insights for stewardship. Pilot analyses using our novel AMROrbit scorecard, applied to data from 80 countries, indicate that over 60% of antibiotic–pathogen combinations exhibit upward resistance trajectories, underscoring the urgency of integrated surveillance and early warning systems.
AMRSense provides clear policy directions for LMICs, including the institutionalization of community-level AMR surveillance in national and state action plans for AMR containment. This involves leveraging digital public infrastructure to track temporal trends, integrating behavioral, consumption, and microbiology data for geographically targeted interventions, and implementing evidence-based stewardship and surveillance using AI and analytics.
Poster Slot
A08
Mental Health and Wellbeing
12:45 - 13:00
Priorities for policy action to address the digital determinants of youth mental health and well-being
| Presenter | : | Aferdita Bytyqi |
| Abstract ID | : | A225 |
Childhood and adolescence are critical periods for mental health: more than half of adult mental disorders have their onset before or during adolescence. As young people spend increasing amounts of their time in digital environments controlled by a handful of powerful tech companies, concern has grown that their use of digital technologies – particularly social media – may be contributing to worsening mental health and well-being.
In response to requests from policymakers, WHO’s Regional Office for Europe and Digital Transformations for Health Lab reviewed scientific literature and policy responses to inform recommendations for addressing the digital determinants of young people’s mental health and well-being. A scoping review of 226 studies examined the current evidence on young people’s technology use and its impact on mental health and well-being. Policy documents from 42 countries were analysed to understand different policy approaches being pursued across the European region and worldwide.
The findings from this research underline the challenge that policymakers face in trying to keep up with the rapidly changing digital landscape and its evolving impacts on young people’s health. In the context of scientific uncertainty and plausible public health threat posed by poorly regulated digital platforms, countries have a responsibility to adopt a precautionary governance approach that seeks to protect young people from potential harms and ensure the safety of online environments.
Eight recommendations have been developed to guide future policy directions. They promote coordinated, multisectoral actions to support digital well-being and counter negative impacts of digital transformations on youth mental health and well-being. Acknowledging the crucial influence of digital platforms on young people's well-being, recommendations advocate for more robust regulation of these platforms and greater accountability within the tech industry. Greater youth participation in designing policies and public health responses is a guiding principle to implement the recommendations.
Poster Slot
B08
12:45 - 13:00
Community engagement and involvement in developing sustainable treatment for anxiety and depression in Indonesia (STAND Indonesia): critical reflections on involvement
| Presenter | : | Sayyid Muhammad Jundullah |
| Abstract ID | : | A189 |
Background: Community engagement and involvement (CEI) is increasingly acknowledged in global health research to leverage the role of individuals with lived experience and communities to improve how research is conducted, recognizing the shift from doing research for to with communities. However, few studies in LMICs critically reflect on how CEI is practiced throughout the mental health research process.
Objectives: This study aims to critically reflect on the work of CEI contributors and researchers within STAND-Indonesia, a global health research group on community-based mental health intervention in Indonesia to increase access to sustainable care for anxiety and depression in Indonesia.
Methods: We evaluated a range of impacts including collaboration and consultation on research, community outreach activities, capacity building within the CEI groups, acceptability of training and outreach with seminars. We adopted a critical reflection approach, drawing on a structured reflective session with CEI contributors and researchers within STAND-Indonesia. We critically reflected on the outcomes and learnings of CEI works.
Results: STAND-Indonesia brings together researchers, an NGO consortium, CEI leads, and a lived experience advisory group (LEAG). Over a three year period, we delivered 20 seminars to enhance research and CEI capacity, organized a mental health festival engaging 289 registered visitors, and conducted more than 50 outreach activities. The LEAG and NGO consortium provided input in eight projects across five work packages to enhance user input. We will report the critical reflection on our activities using the NIHR CEI guiding principles, evaluating on how CEI is practiced.
Conclusions: Our findings suggest that integrating CEI strengthens research relevance and ethical integrity, while fostering public awareness of mental health. These learnings can inform future CEI practices within and beyond STAND-Indonesia, highlighting its pivotal role in bridging researchers, lived experience contributors, and communities.
Poster Slot
C08
12:45 - 13:00
Barriers to accessing healthcare among Forcibly Displaced Myanmar Nationals residing in refugee camps in Bangladesh: A cross-sectional survey
| Presenter | : | Mohammad Samiur Rahman Chowdhury |
| Abstract ID | : | A235 |
Background: Cox’s Bazar hosts nearly 960,000 Forcibly Displaced Myanmar Nationals (FDMN), predominantly Rohingya, who fled targeted military violence in Myanmar the largest displacement occurring in 2017. While they found safety in Bangladesh, they continue to face numerous challenges, including barriers to healthcare access that may delay care and worsen health outcomes. This study aimed to explore and describe such barriers among the FDMN population during March-May 2024.
Methods: A cross-sectional survey was conducted in two phases. In phase one, a random sample of inpatients and outpatients was recruited from four health facilities; in phase two, participants were selected from the community through random sampling across thirteen camps. Trained community-based data collectors administered surveys via KoBoCollect. Frequency counts and proportions summarized the findings.
Results: A total of 1,473 facility participants and 207 community participants completed the survey. Most were female 75% and married 91%. The majority were aged 15-44 years (facility: 77%; community: 67%). Overall, barriers to healthcare were reported by 90% of facility respondents and 73% of community respondents. Nearly half of facility participants 49% reported the absence of appropriate care services at nearby facilities, and 22% expressed concerns about care quality. Security checkpoints were reported as barriers by 27% of facility respondents and 25% of community respondents. Lack of transport (26%-27%) and long walking distances (31%-36%) were also common. Financial barriers included borrowing money (13%-17%) and, among community respondents, selling rations 33% to cover healthcare costs. Over half 56% of facility participants reported delaying care due to these barriers.
Conclusion: Barriers to healthcare among the Rohingya in Cox’s Bazar are widespread, spanning perceived service gaps, quality concerns, transportation challenges and restrictive security measures. Addressing these multifaceted barriers is essential to improve timely healthcare access and reduce preventable morbidity in this vulnerable population.
Poster Slot
D08
12:45 - 13:00
Climate Change and Youth Mental Health: A Cross-Regional Study from India and Hong Kong
| Presenter | : | Mercian Daniel |
| Abstract ID | : | A117 |
Background: Climate change poses a growing threat to mental health, yet its psychological impacts on young people, especially in Asian and low-and-middle-income countries remain underexplored. While emerging evidence from Hong Kong highlights climate-related emotional distress among youth, there is a critical gap in research from India. Young people, particularly those from marginalised communities, face both direct and indirect consequences of climate change, including extreme weather events, environmental degradation, and socio-economic stressors. Understanding their perceptions, emotional responses, and capacity for climate action is essential for developing targeted mental health interventions.
Aims and Objectives: This study aimed to examine links between climate change and mental health (depression, anxiety) among young people aged 14-24. The specific objectives were:
1. Assess mental health status, risk, and life satisfaction of participants.
2. Evaluate climate change knowledge and awareness among young people.
3. Explore perceptions, emotions, and psychological impacts of climate change.
4. Understand levels of concern, hope, agency, and engagement related to climate action.
Method: Cross-sectional surveys were conducted with 536 marginalised youth in urban slums of North and South India, and 1597 youth from rural Sundarbans (West Bengal) and educational institutions in Hong Kong. Data collection involved mobile-based surveys in India and online/paper-based surveys in Hong Kong.
Results and Conclusion: Regions directly affected by climate change reported the highest negative climate impacts, feelings, and concern, while urban slums in India showed the lowest agency and engagement. Climate-related stressors (e.g. water salinity, livelihood loss, pollution) and negative emotions significantly increased depression and anxiety risk. Protective factors included gender, education, income, awareness, and life satisfaction. Climate change disproportionately affects the mental health of vulnerable populations and psychosocial determinants play a critical role. The study underscores the universal mental health impact of climate change and the need for integrated mental health strategies within climate action plans.
Poster Slot
E08
13:00 - 13:15
NapJai: AI-enabled, community-based digital sanctuary for people-centred mental health support in Thailand
| Presenter | : | Nichapha Chaisuriyanuthit |
| Abstract ID | : | A159 |
Mental disorders are a leading cause of disability in Thailand, with demand for support rising amid rapid demographic change and post-pandemic pressures. Persistent access barriers—including workforce shortages, stigma, geographic distance, and long waiting times—disproportionately affect rural and underserved communities, deepening inequities in care. With more than 90% of Thai households owning at least one smartphone (NBTC, 2024), there is a significant opportunity to expand access through scalable, equity-driven digital solutions.
NapJai—meaning “to ease the heart”—is a proposed Thai-language web application offering anonymous, 24/7, people-centred mental health support. The platform integrates empathetic AI–supported emotional check-ins, weekly mood tracking with personalized insights, and an optional peer “listening” space governed by safety protocols and referral pathways. By providing discreet, stigma-free access, NapJai aims to reach individuals who might otherwise never seek support, presenting an innovative model for health system transformation.
Early conceptual development drew on insights from students, young workers, and community volunteers, with participatory co-design sessions planned for the development phase. Following iterative usability testing, a mixed-methods pilot study is planned for Q1 2026 with more than 200 participants, pending completion of usability testing and ethical approval. Evaluation will include K6 and PHQ-9 assessments (baseline, day 7, and day 20), analytics on onboarding, adherence to weekly check-ins, 30-day retention, and patterns of peer interaction. Qualitative interviews will explore perceptions of safety, empathy, and usefulness.
Governance will follow privacy-by-design principles, including informed consent, de-identification, and human oversight for crisis triage with direct linkage to Thailand’s 1323 national mental health hotline. Pilot targets include ≥70% onboarding completion, ≥80% weekly check-in adherence, ≥0.5 SD symptom improvement in ≥50% of users, ≥30% 30-day retention, and more than 100 supportive peer interactions with minimal moderation needs.
If successful, NapJai could inform national digital mental health policy, generate anonymized population insights for planning, and provide a scalable model for resource-limited settings—advancing equity, resilience, and people-centred health system transformation.
Poster Slot
A09
13:00 - 13:15
Depression on Survival Among Chinese Older Adults
| Presenter | : | Jianxing Liu |
| Abstract ID | : | A204 |
Background: China is among the fastest-aging countries globally. Depression, a prevalent mental health issue in older adults, presents significant global health, economic, and social challenges. The disease and financial burdens and stigma of depression in China underscore the urgency of understanding its link with all-cause mortality. While prior studies have linked single-measured depression with increased mortality risk, its long-term impact and potential gender differences remain underexplored. Moreover, many studies incorporated sleep issues into depression measures, potentially overlooking the independent effect of sleep.
Objectives: This study aimed to investigate the association between depression and all-cause mortality among older Chinese adults, assessing the mediating role of sleep duration and potential gender differences while considering changes in prognostic factors over time.
Methods: Prospective data were from the 2008-2018 waves of the Chinese Longitudinal Healthy Longevity Survey, from which three cohorts of individuals aged ≥ 65 (N=11,533 in 2008; 6,783 in 2011; 3,458 in 2014) were constructed. Depression was measured on a five-item scale (score range: 0-20), with higher scores indicating greater symptom severity. Cox proportional hazards regression was applied to estimate mortality risk. A three-step estimation method examined sleep duration as a potential mediator. Subgroup analyses explored possible differences in the depression-related mortality risk between male and female participants.
Results: Higher depression scores were significantly associated with increased mortality risk across three cohorts, especially among male participants, with the association strengthening from the 2008 cohort (HR=1.021) to the 2014 cohort (HR=1.033). Sleep duration was positively associated with increased mortality risk and consistently mediated the relationship between depression and mortality.
Conclusions: Depression was a significant predictor of mortality risk in older Chinese adults, especially for males, with sleep reduction counteracting this risk. Findings underscore the need for a thorough support system from government, health organizations, and other relevant policymakers to promote healthy aging.
Poster Slot
B09
13:00 - 13:15
Neighbourhood Environments and Later Life Flourishing: A Systematic Scoping Review
| Presenter | : | Yeqing Zhang |
| Abstract ID | : | A249 |
Background
Enabling older people to live comfortably in their own neighbourhoods for longer, known as ageing-in-place, has become a policy priority to reduce pressures on health and social care systems amid global population ageing. However, research on place and health remains predominantly deficit-focused, emphasising illness and decline (e.g. frailty, depression, and anxiety). This review adopts a positive psychology perspective and a life-course framework to synthesise evidence on how neighbourhood environments support flourishing in later life, a multidimensional state encompassing happiness, life satisfaction, and meaning in life.
Methodology
Searches were conducted across nine databases. Content analysis was used to synthesise findings, guided by an adapted version of Wahl, Iwarsson and Oswald’s person-environment framework of ageing well. Risk of bias was assessed using the NHLBI Quality Assessment Tool.
Results
From 3,375 records, 52 studies met the inclusion criteria. Consistent positive associations were identified between neighbourhood physical characteristics (e.g. green space, littering) and social characteristics (e.g. ageism, social cohesion) and older adults’ flourishing. Findings on the functional characteristics (e.g. service accessibility and transport) varied by service type and measurement approach. Compositional characteristics (e.g. age mix, socioeconomic status) significantly moderated person-environment interactions but remain underexplored. The evidence base overall is limited by reliance on cross-sectional data. Few studies explicitly adopted a life-course lens, limiting understanding of cumulative and temporal effects.
Conclusion
Neighbourhoods play a crucial role in supporting older adults’ flourishing, but evidence on causal pathways and life-course dynamics remains limited. The proposed integrative framework enhances conceptual clarity and provides a foundation for longitudinal research to guide place-based interventions for positive ageing.
Poster Slot
D09
Gender, Women's Health, and Child Health
13:00 - 13:15
Community dynamics on influencing HPV vaccine uptake amongst girls in the Pacific Islands.
| Presenter | : | Ki Fung Kelvin Lam |
| Abstract ID | : | A054 |
Community dynamics play a significant role in influencing the uptake of public health interventions. Despite vaccines being considered as public health ‘best-buy’, both Samoa and the Kingdom of Tonga have struggled in attaining the target 80% coverage since the introduction of the Human Papilloma Virus (HPV) vaccine in 2021. The HPV vaccine was introduced with support from a regional ADB project with the objectives to reduce four Pacific island countries’ burden against vaccine preventable diseases, integrate immunization program into broader health systems, and improve access to primary healthcare services.
An informal equity study was conducted in four Pacific island countries to examine to reasons for vaccine refusal amongst unvaccinated girls who were eligible for HPV vaccination. A qualitative approach through focus-group discussions and individual interviews with unvaccinated girls, parents and caregivers, and healthcare and school workers were conducted to understand the social factors influencing vaccine uptake.
The study identified peer influence amongst girls as a crucial factor, as many unvaccinated girls expressed a desire to receive the vaccine when their friends or a role model had also received the vaccine. There were also gender differences in vaccine-related fears, with mothers more concerned about acute reactions and side effects, whilst fathers expressed concerns on misinformation around infertility and sexual reproductive health. Amongst the wider social network, many caregivers and teachers highlighted a gap in communication and information provided to address specific concerns within the communities.
Overall the findings suggest that community-based approaches, including peer influence amongst family and the community, are essential for improving HPV vaccine update in two Pacific island countries. Enhancing interpersonal communication and providing culturally appropriate information can help address vaccine hesitancy and improve social equity.
Poster Slot
C09
13:00 - 13:15
Integrated care centers in Benin: a holistic approach to address gender-based violence survivors’ mental health
| Presenter | : | Pacôme Sênoudé Tomètissi |
| Abstract ID | : | A055 |
Gender-based violence’ public policies in Benin have focused heavily on repression. The legal framework contributed to tracking down a significant proportion of technology-facilitated gender-based violence perpetrators. However, gender-based violence still affects 69% of women, while only 46% of them report it. In addition, social constraints and the complexity of the judiciary facilitate impunity and worsen survivors’ mental health.
To deal with these challenges, the government with the support of key technical and financial partners implemented an integrated approach to care for victims and survivors of gender-based violence in four provincial public hospitals to provide prompt, coordinated, appropriate, and sustainable solutions to the health, social, psychological, and legal needs of victims.
Preliminary results of the initiative indicate that the integrated care approach reduced stigma, bureaucracy, increased cases reporting and provided a more effective and cost-effective response for gender-based violence survivors.
Data revealed that 13,465 gender-based violence cases were reported in 2020, 12,120 in 2021, 16,261 in 2022, 16,623 in 2023, and 19,421 in 2024. From 2020 to 2024, the cases by province were 3,372 in Alibori, 3,142 in Atacora, 6,078 in Atlantique, 6,392 in Borgou, 5,035 in Collines, 4,149 in Couffo, 2,393 in Donga, 1,504 in Littoral, 4,475 in Mono, 7,018 in Ouémé, 5,289 in Plateau, and 9,590 in the Zou.
From 2020 to 2024, the integrated care centers were able to support 26,983 survivors of which, 7,909 cases were sent to the courts and 3,871 received health care.
Despites these achievements, the capacity of the four integrated care centers in covering the whole country is limited.
Future directions may include a generalisation of the integrated care approach for survivors of gender-based violence to improve accessibility as an essential step towards health for all.
Poster Slot
E09
13:15 - 13:30
Hidden Workforce: the unique contributions of older women to the global economy
| Presenter | : | Ann Keeling |
| Abstract ID | : | A078 |
Older women form an integral part of the global economy, but their work often goes unrecognised - they are a hidden workforce. Age International's research shows that without their vital contributions, households would lose out on economic and social opportunities, communities would be less cohesive, and society would struggle to function fully.
As they reach older age, the gendered inequalities that women have faced throughout their life course are compounded, and they are often excluded from financial systems, and their right to equitable social protection. For example, access to contributory pensions is usually tied to formal employment and contribution histories, and women are disproportionately excluded from these systems. In low and middle income countries only around 20% of the total population have access to a pension, and women are far less likely to have access to one than men. Recent research by HelpAge in Ukraine found that women’s pensions are around 30% lower than men’s.
Older women perform multiple roles - as workers, educators, community volunteers, carers, grandmothers - but in this time of demographic transition, and changing social contexts, where traditional support mechanisms are often fractured, the support they need to keep fulfilling these roles is falling short.
Social pensions could help to tackle the cumulative impacts of a lifetime of gendered inequalities and improve the resilience of multigenerational households. In Tanzania, for example, older women receiving cash transfers through the national social pension scheme reported being able to support their grandchildren through education.
Social protection systems must be age-inclusive, shock-responsive, gender transformative and developed in collaboration with older women to respond to their needs.
Social pensions are a key solution available to governments to support older women in the crucial roles they play in the economy and society and to address gender inequity in older age.
Poster Slot
A10
13:15 - 13:30
Is innovation the future of global health? Lessons from Tanzania and India
| Presenter | : | Haitham El-noush |
| Abstract ID | : | A090 |
Overview
Innovation has been one of the pillars for Norway’s global health efforts during the last 25 years, with great success in bending the mortality curve.
With the decline in development aid for health and the current seismic geopolitical changes, the role of innovation is back on the agenda. We wish to share lessons from Tanzania and India on how to reduce maternal, newborn, and child mortality; aiming to provide evidence and policy inferences through showcasing achievements, synthesizing lessons learned, and exploring synergies for South-South collaboration.
Lessons from Tanzania
The Safer Births Bundle of Care program integrates innovative interventions to improve care quality for mothers and babies, aiming to lower birth-related mortality. It was a three-year stepped-wedge cluster-randomized study conducted across 30 high-burden facilities in five regions of Tanzania, involving nearly 300,000 mother-baby pairs. The program's interventions included regular onsite simulation-based training, collection and use of local clinical data, support from trained local facilitators, and innovative low-cost clinical and training tools for perinatal care. The results show that the estimated incidence of perinatal death dropped by 18%, 24-hour newborn mortality decreased by 40%, and maternal mortality dropped by 75% (https://www.nejm.org/doi/full/10.1056/NEJMoa2406295).
Lessons from India
Backed with highest political commitment since 2006, the ‘Norway India Partnership Initiative (NIPI)’ has evolved into a strategic, innovative and catalytic platform for health systems innovation. The process involved incubation, demonstration on existing public health infrastructure, scientific methods validation, scaling through domestic financing and institutionalisation into health programs.
By scaling NIPI’s innovations across 600 districts, impacting 75 million children and women annually, and boosting India’s health spending by 26 times Norway’s contribution, NIPI drove significant progress: under-five mortality dropped from 74 to 30, infant mortality from 57 to 28, neonatal mortality from 37 to 20, and maternal mortality from 280 to 97 (https://www.norad.no/en/publications/2024/end-review-of-the-norway-india-partnership-initiative-nipi-phase-iii/).
Poster Slot
B10
13:15 - 13:30
Updating the Evidence: Cost-Effectiveness of Early Childhood Nutrition and Development Interventions (2013–2024) to Guide Health System Transformation
| Presenter | : | Qi Rui Soh |
| Abstract ID | : | A125 |
Background: Early childhood nutrition and development (ECND) interventions are widely regarded as among the most powerful investments for improving population health, human capital, and long-term economic productivity. A 2014 systematic review identified only 15 economic evaluations, largely from high-income countries and with substantial methodological heterogeneity. Given the rapid expansion of the ECND evidence base over the past decade, an updated synthesis is required.
Methods: We updated the 2014 review by searching MEDLINE, Embase, and Web of Science (2014–2025) for full economic evaluations of ECND interventions delivered in the first five years of life. Data were extracted on study characteristics, perspective, time horizon, cost components, outcome measures, and uncertainty analysis. DALY-based ICERs were inflated to 2024 USD and treated as 2024 international dollars (Int$) for comparability. ICERs were benchmarked against country-specific GDP-based cost-effectiveness thresholds. Descriptive synthesis was conducted by intervention category, income level, and methodological quality.
Results: Sixty-two studies across 32 countries were included, with 79% conducted in low- and middle-income countries. The largest intervention categories were nutrition/feeding (36%) and integrated multi-domain programmes (31%). Harmonised DALY-based ICERs ranged from Int$16.6 to Int$909 per DALY averted (median Int$100). Using GDP-based thresholds, 40% of studies were highly cost-effective, 17% cost-effective, and 11% cost-saving. Persistent methodological limitations included infrequent use of societal perspectives (27%), limited probabilistic sensitivity analysis (13%), and incomplete reporting of price years and cost components.
Conclusions: A decade after the original review, the ECND economic evidence base has expanded substantially, with most DALY-based evaluations demonstrating high cost-effectiveness or cost savings. Nonetheless, important methodological gaps remain in outcome standardisation, uncertainty analysis, and scalability assessment. Strengthening ECND-specific economic evaluation standards is essential to enhance policy relevance and comparability.
Poster Slot
C10
